Matthew Blaisdell, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19636 Issued in WI

Practice address

2480 Sonoma St
Redding, CA 96001

Phone

(530) 225-7800

NPI assigned

May 4, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1780039164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE.",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-225-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 SONOMA ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96001",
            "telephone_number": "530-225-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "MATTHEW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "19636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keri Michele Bither-Barnes, D.C. DACNB
• Aaron Michael Bjarnason, D.M.D
• Naomi Grace Bjorgan, LM
• Dana Jo Blair
• Clair Angelique Blais, RN
• Blakecis, Inc.
• Duane David Bland, M.D.
• Tikoes A. Blankenberg, M.D.
• Sally Ann Blankenship, M.A., CCC-S.P.
• Kierra Blaser

• Family Medicine Physician in Redding, CA
• Providers in Redding, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.